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Swimmer puppy syndrome (SPS) is a rare condition that affects neonatal animals. The affected puppies are unable to stand, remain in sternal recumbency with their legs splayed laterally and ambulate with typical swimmer-like movements. This study reports the clinical findings and discusses the treatments and outcomes in four puppies of various breeds with clinical signs of SPS. Previous medical records of the animals were reviewed for history, clinical features, radiographic findings and choice of treatment. Treatment follow-up was evaluated at 15, 30, 45 days and 6 months. In three puppies all limbs were affected. In one case only the forelimbs were affected, while the hind limbs remained normal. Clinical, orthopaedic and neurological examinations, routine laboratory findings and tidal breathing flow-volume loop measurements were normal. Concurrent problems occurred in two animals and included slightly deformed chest and ventrodorsal flattening of the thorax with a slight right displacement of the heart. For the management of SPS, chest and hobble bandages were used, as well as physiotherapy and environmental management. Three puppies recovered completely after 45 days of treatment. In one case the therapy was discontinued after 2 weeks. In this case, the puppy could stand, but mild abduction of the forelimbs and lameness were obvious after 6 months. Intensive physiotherapy contributed to positive outcomes even in older puppies. Also, to the authors' knowledge, this is the first report of tidal breathing flow-volume loop measurement for dogs with pectus excavatum., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Postural assessment is an important part of the veterinary evaluation of a dog's neuromusculoskeletal function. It forms an important part of the clinical examination by physiotherapists and specialists in veterinary rehabilitation and sports medicine and is well researched in humans, which has allowed treatment approaches to be developed and validated. This narrative review aims to complement the veterinary literature, which largely quantifies the impact of various conditions on posture, by synthesising the physiotherapy literature, to help translate the use of postural assessment as a basis for the development and validation of treatment techniques to improve outcomes in dogs., Competing Interests: Declaration of Competing Interest None of the authors of this paper has a financial or personal relationship with other people or organisations that could inappropriately influence or bias the content of the paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Outcome measures are extensively used within human physiotherapy, but a widely accepted issue in veterinary physiotherapy is that outcome measures lack sufficient evaluation and standardisation in terms of how they are implemented. This cross-sectional study aimed to provide clarity on (1) the current selection of outcome measures in canine and equine physiotherapy and (2) investigate external influences on outcome measure selection, including comparative literature availability, professional memberships and background., Methods: A structured scoping literature review consolidated current understanding and limitations. This informed a survey of qualified veterinary physiotherapists (n = 40). The statistical analysis comprised descriptive statistics., Results: Key observations included (1) a lack of difference in outcome measure application between veterinary physiotherapists with and without a human physiotherapy background, (2) enhanced outcome measure utilisation by registry body members and (3) an overall skew towards subjective, rather than objective, outcome measure use., Limitations: The study was limited by the absence of a defined veterinary physiotherapist population and subsequent convenience sample size., Conclusion: The apparent skew towards subjective outcome measures highlights objective outcome measure underutilisation and the need for a more extensive evidence base. In conclusion, there is a need to develop comprehensive professional development resources promoting the use of repeatable outcome measures such as goniometers and the Liverpool osteoarthritis scoring., (© 2024 The Authors. Veterinary Record published by John Wiley & Sons Ltd on behalf of British Veterinary Association.)

Background: Over-the-wire (OTW) catheter placement is performed frequently in horses. Intravascular loss of a guidewire has been anecdotally reported, but there is limited information regarding the treatment and outcome of horses that have experienced this complication of OTW catheter placement., Objectives: Describe the clinical and diagnostic features, treatment, and outcome of horses experiencing IV guidewire loss at the time of OTW catheter placement., Animals: Thirteen horses., Methods: Multicenter retrospective study to identify horses with IV guidewire loss. Horses of all ages were considered for inclusion. Horses were excluded from the study if complete medical records of signalment, indication, and outcome were not available. Intravenous guidewire loss was defined as the guidewire being lost IV at the time of OTW catheter placement., Results: No horses in this study experienced adverse clinical signs associated with the loss of a guidewire. Eight horses had the guidewire removed and the guidewire was left in situ in 5 horses. None of the horses with the guidewire in situ had experienced long-term effects., Conclusions and Clinical Importance: Intravenous guidewire loss seems to have a good long-term prognosis even in horses in which removal of the guidewire was not possible. Thus, in horses where guidewire removal is not feasible, guidewires that remain in situ may have limited to no adverse effects., (© 2023 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

Manual therapy is a cornerstone of physical therapy and canine physical rehabilitation. Although veterinary literature has tackled the topic of manual therapy treatments in animal patients, less attention has been paid to the assessment techniques and clinical reasoning skills that guide a practitioner toward determining if, when, and where manual therapies will be most effective. This article tackles the topics of clinical reasoning, the functional diagnosis, observational skills, and physical evaluation techniques that serve as prerequisites to the use of manual therapeutics., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Millie Byrne decided a quiet life wasn't for her and completed a master's degree in veterinary physiotherapy - and before she'd even finished she had taken the plunge and started her own business., (© 2023 British Veterinary Association.)

A comprehensive mobility assessment goes beyond the orthopedic or neurologic examination for the localization of pathology. This assessment involves attention to the dog's posture and stance, a hands-on examination with special attention to soft tissue structures, and the performance of functional assessments. A comprehensive mobility assessment can guide advanced diagnostic testing as well as providing a foundation in the formulation of a successful treatment plan., Competing Interests: Disclosure The author has nothing to disclose., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Physical rehabilitation incorporates several elements, including but not limited to therapeutic exercises, manual therapy, and physical modalities. Understanding of the effects, indications, contraindications, and precautions is essential for proper use, while understanding of the diagnosis, assessment of the stage of tissue healing and repair, and accurate clinical assessment of the functional limitations are essential when establishing a physical rehabilitation plan., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Horses preparation for competition may cause psychological and physical stress. Physical vascular therapy BEMER® is reported to increase vasomotion and microcirculation, supporting body healing. This study aimed at assessing whether BEMER® physical vascular therapy in horses influences recovery rate of hematological and biochemical blood parameters within 1 h after moderate exercise and reduces stress measured by physiological and behavioral indicators. This prospective, randomized, double blinded, placebo-controlled crossover study included twelve warmblood horses (3 mares, 8 geldings, 1 stallion). Additionally to their daily work, horses were subjected to 15 min of exercise on a longe. Horses were randomly divided in two groups: A (n = 6), B (n = 6). Group A underwent first to BEMER® blanket for two weeks, then to Placebo blanket for two weeks. Group B did the opposite. Blood samples, thermographic infrared images, Heart Rate Variability and behavior were analyzed. ANOVA was used to investigate any treatment effect. After two weeks of treatment, although not statistically significant, hematocrit (%) measured immediately post exercise was lower in horses undergoing BEMER® treatment (48.30% ± 3.21) than both No blanket (51.15% ± 3.57) and Placebo blanket (49.58% ± 5.77). While wearing BEMER® blanket and after treatment, horses had a lower LF/HF ratio compared to other groups, although this difference was not statistically significant. These results possibly suggest an effect of BEMER® therapy on vagal activity and relaxation. Substantial progress in recovery after exercise was not confirmed, leading to the need for further investigation on the overall effect of BEMER® therapy., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Prolonged slow expiration (PSE) and assisted cough (AC) are airway clearance techniques feasible and well tolerated in dogs., Objectives: To evaluate the effectiveness of PSE and AC as chest physiotherapy (CP) techniques in dogs with airway fluid accumulation., Animals: Thirty-one client-owned dogs hospitalized in an intensive care unit from October 2014 to May 2018., Methods: Prospective randomized controlled trial. Dogs presented with or developing acute dyspnea during hospitalization associated with airway fluid accumulation were assigned to CP group (medical treatment and CP, 15 dogs) or control group (medical treatment alone, 16 dogs). The arterial partial pressure of oxygen (PaO 2 ) to fraction of inspired oxygen (FiO 2 ) ratio (P/F ratio; PaO 2 /FiO 2 × 100) was calculated daily for the 1st 48 hours of hospitalization and using the last arterial blood gas performed before discharge or death. The ratio of days of hospitalization with oxygen/total number of hospitalization days (ratio of oxygen-free-days [O 2 Free]) was calculated., Results: During the 1st 48 hours, the P/F ratio increased significantly in the CP group compared to the control group (+ 35.1 mm Hg/day; 95% confidence interval [CI] = 0.4-57.5; P = .03). The (median; 1st quartile to 3rd quartile) difference between the P/F ratio at discharge and inclusion was significantly higher in the CP group (178 mm Hg; 123-241) than in the control group (54 mm Hg; -19 - 109; P = .001). Mean O 2 Free increased by 46.4% in the CP group compared with control group (95% CI = 16-59; P = .001). Mortality was 13% (2/15) in the CP group and 44% (7/16) in the control group (P = .07)., Conclusions and Clinical Importance: Prolonged slow expiration and AC improved P/F ratio within 48 hours and decreased need for oxygenation in dyspneic dogs with acute airway fluid accumulation., (© 2021 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

The goal of rehabilitation is to restore function and mobility and reduce pain associated with chronic disease. In human medicine, physical therapy is standard of care for acute and chronic injuries and an integral component of postoperative recovery. Although there is a dearth of evidence-based veterinary medical studies in rehabilitation therapy and modalities for forelimb injuries in dogs, some extrapolation from human medicine can be made and applied. When developing a rehabilitation and therapeutic plan, the biomechanics of the affected limb and timeline of tissue healing of the target tissue and/or joint are important to consider., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Physical therapy and rehabilitation following orthopaedic surgery in companion animals have become more common and new advancements in this field have been made in recent years. Surgery alone may not return the animal to its previous physical activity or work-related tasks, whether due to concurrent soft tissue trauma, arthrogenic muscle inhibition or osteoarthritis. Rehabilitation therapies following surgery can restore function as well as strength, coordination and balance. Many simple techniques such as cryotherapy and passive range of motion exercises have been shown to improve outcomes following musculoskeletal procedures and may help restore function as well as reduce pain and facilitate healing. Some techniques are more useful during different stages in order to achieve optimum tissue healing and recovery of function. During the first 72 hours, rehabilitation should focus on reduction of inflammation and pain, maintaining joint nutrition and range of motion, and stimulating vascularisation and healing; and may include cryotherapy, passive range of motion exercises, massage and therapeutic exercises. Following the initial recovery period, the goals of rehabilitation also include restoring strength, balance and normal gait patterns, as well as recovery of function. During this period the focus of therapy may shift toward therapeutic exercises, aquatic therapy and increasing activity in the animal. Therapeutic modalities such as neuromuscular electrical stimulation, photobiomodulation (laser therapy), therapeutic ultrasound and extracorporeal shock wave therapy have been reported to reduce pain and inflammation, enhance healing and reduce recovery time in the early and late stages following orthopaedic surgery.

Due to advances in captive nonhuman primate (NHP) medical care, the number of geriatric chimpanzees (≥35-years old) is growing. With old age comes a variety of physical conditions, including arthritis, stroke, and mobility impairments. Programs aimed at enhancing the welfare of geriatric chimpanzees are now quite common, but there are few published empirical evaluations of the efficacy of such programs. The current study aimed to create, implement, and evaluate the effects of participation in a physical therapy (PT) program on physical health, mobility, welfare, and behavior. Nine chimpanzees with mobility impairments participated in personalized PT routines (using positive reinforcement training) twice per week for 5 months. Additionally, nine control chimpanzees (non-mobility-impaired, matched with PT chimpanzees on age and gender) participated in body exam behavior sessions (also using positive reinforcement training) twice per week. All chimpanzees were rated on 14 health, well-being, and behavior items, as well as level of mobility throughout the PT program. Chimpanzees that participated in the PT program showed significant increases in ratings of physical health, well-being, and activity levels across phases of the program. Furthermore, compared to control chimpanzees, PT chimpanzees showed significant increases in ratings of ease of movement. Because raters were not blind to physical therapy treatment, our results represent an initial evaluation of the program that may suggest that participation in the PT program has physical, behavioral, and welfare benefits. Assessments of novel geriatric-focused care strategies and programs are essential to further enhance the welfare of the captive chimpanzee population, which is currently comprised of many geriatric animals, whose proportion of the captive population will only increase., (© 2020 Wiley Periodicals, Inc.)

Objective: To report current recommendations made by veterinarians for rehabilitation after surgical treatment of cranial cruciate ligament (CrCL) disease., Study Design: Anonymized electronic survey., Sample Population: Veterinarians performing CrCL stabilization., Methods: An electronic survey was created to collect information on general attitudes toward postoperative rehabilitation and recommendations regarding therapeutic modalities and bandaging. Quantitative data are reported by descriptive statistical analysis, percentage of responses, or mean (±SD). The recommendations for postoperative bandaging beyond 24 hours and for postoperative rehabilitation after extracapsular stabilization compared with after tibial osteotomy were tested by using Cochran-Mantel-Haenszel tests, with P < .05 considered statistically significant., Results: The data analysis included 376 responses (13% response rate). Most (71%) respondents consistently recommended postoperative rehabilitation. Rehabilitation was more than twofold more likely to be recommended after extracapsular stabilization than after osteotomies (P = .0142). Most respondents did not recommend bandaging beyond 24 hours postoperatively (P = .00012)., Conclusion: Most respondents recommended either formal or informal postoperative rehabilitation therapy., Clinical Significance: If the survey respondents are representative of veterinarians performing CrCL surgery, the current attitude is supportive of postsurgical rehabilitation. Most respondents would welcome evidence-based guidelines for rehabilitation protocols., (© 2019 The American College of Veterinary Surgeons.)

Objective: To review fundamental principles of tissue healing and physical rehabilitation as they apply to dogs recovering from cranial cruciate ligament (CCL) surgery., Study Design: Invited Review., Sample Population: None., Methods: A multidisciplinary group of specialists in small animal surgery, rehabilitation/sports medicine, and human physical and occupational therapy reviewed the currently available evidence for rehabilitation post-CCL surgery. Because current evidence is limited, this group proposes guidelines for rehabilitation after CCL surgery based on the fundamental principles of tissue healing and physical therapy., Results: This Review proposes four fundamental principles of small animal physical rehabilitation based on the foundations of tissue healing and patient-centric and goal-oriented therapy. Postoperative rehabilitation programs should be designed such that patient progress is based on individual assessment according to the degree of tissue healing, strength, and achievement of functional goals. Therapists must fully understand phases of tissue healing, reassess the patient frequently, and use clinical reasoning skills to progress treatment appropriately for the individual patient., Conclusion: Until more robust evidence is available to guide treatment protocols, fundamental principles of rehabilitation should ideally be adhered to when providing rehabilitation, including after CCL surgery., Clinical Significance: While this Review specifically addresses post-CCL surgery rehabilitation, these fundamental principles should be applied broadly to animals enrolled in rehabilitation programs., (© 2019 The Authors. Veterinary Surgery published by Wiley Periodicals, Inc. on behalf of The American College of Veterinary Surgeons.)

Aim: To evaluate clients' understanding, perception and experience of postoperative physiotherapy after undergoing an osteotomy technique for cranial cruciate ligament disease (CCLD)., Method: A retrospective questionnaire was sent to 202 owners of dogs that underwent CCLD surgery at the Queen Mother Hospital for Animals between 1 January 2015 and 31 December 2017, with 63 responses obtained., Results: Significant differences were found in choice of physiotherapy between clients recommended or not by their vets (p<0.01), and between those offered additional information and those who were not (p<0.01). Of those who chose physiotherapy, 85% had a satisfactory experience. No difference was found in choice of physiotherapy between clients aware of its availability and those who were not (p=0.069). No association was found between cost of the service and clients' perception of cost-worthiness (p=0.169) or between cost-worthiness and recovery outcome (p=0.420). A correlation was found between clients' perception of cost-worthiness and satisfaction level (p=0.03). Clients' knowledge was related to the choice of physiotherapy (p=0.01), but not to other investigated factors. A significant relationship was found between clients' age and choice of physiotherapy (p=0.01), with younger clients choosing physiotherapy more often., Conclusion: Veterinarians recommending physiotherapy and providing accurate information affect clients' decision to choose, and perception of, physiotherapy, in addition to clients' own knowledge., Competing Interests: Competing interests: None declared., (© British Veterinary Association 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Objective: To evaluate the feasibility, benefits, and adverse effects of prolonged slow expiration (PSE) and assisted cough (AC) as chest physiotherapy (CP) techniques in dogs with airway fluid accumulation., Design: Prospective interventional study., Settings: University teaching hospital., Animals: Intervention group of 30 client-owned dogs and retrospective control group of 71 client-owned dogs., Interventions: PSE was performed on dogs with evidence of airway fluid accumulation, identified based on physical examination and thoracic radiographs. AC was performed if spontaneous cough or swallowing were not evident. The PSE treatment was performed every 6 hours until normalization of respiratory status or hospital discharge. Animals were monitored for respiratory distress, discomfort, and SpO 2 during the procedure. A retrospective control group was identified by computer search., Measurements and Main Results: One hundred thirty-three sessions of CP were performed on 30 dogs. Discomfort frequency during physiotherapy was low (9%). The most commonly used position for CP was in lateral recumbency (95%) and this was well tolerated in most cases. There was no significant difference in the median SpO 2 before and after CP sessions (P = 0.24). Sixty percent of sessions had a spontaneous cough or swallowing evident, 21% had successful AC performed, and no cough or swallowing occurred in the remaining (19%) sessions despite attempts of AC being made. The length of hospitalization was significantly longer in the intervention group (6 days vs 4) (P = 0.02). There was no difference in survival between the intervention (76.7%) and the control (57.7%) group (P = 0.055)., Conclusions: PSE associated with AC are easily adaptable, well-tolerated techniques in dogs. The benefit of CP in dogs with airway fluid accumulation remains to be determined and it is hoped that future randomized controlled prospective studies may help answer this line of inquiry., (© Veterinary Emergency and Critical Care Society 2018.)

Hip dysplasia is among the most common orthopedic conditions affecting dogs. Joint laxity is responsible for abnormal development of the femoral head and acetabulum, leading to excessive wear of the articular cartilage. Wear leads to secondary osteoarthritis. Rehabilitation is either conservative or after surgical management. Conservative rehabilitation therapies are directed at decreasing pain, improving hip range of motion (ROM), and building or maintaining muscle mass. Postoperatively, rehabilitation focuses on decreasing postoperative pain and inflammation, improving comfort and limb use, and protecting the surgical site. Once the patient has healed, rehabilitation is directed at improving ROM and promoting muscle mass., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Hip dysplasia (HD) is a common orthopedic condition seen in small animal patients that leads to osteoarthritis of the coxofemoral joint. The disease can be managed conservatively or surgically. The goals of surgical treatment in the immature patient are to either prevent the clinical signs of HD or to prevent or slow the progression of osteoarthritis. In mature patients surgery is used as a salvage procedure to treat debilitating osteoarthritis. Conservative management can be used in dogs with mild or intermittent clinical signs and includes nutritional management and weight control, exercise modification, physical rehabilitation, pain management and disease-modifying agents., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: Spinal walking (SW) is described as the acquisition of an involuntary motor function in paraplegic dogs and cats without pain perception affected by a thoracolumbar lesion. Whereas spinal locomotion is well described in cats that underwent training trials after experimental spinal cord resection, less consistent information is available for dogs., Hypothesis: Paraplegic dogs affected by a thoracolumbar complete spinal cord lesion undergoing intensive physical rehabilitation could acquire an autonomous SW gait under field conditions., Animals: Eighty-one acute paraplegic thoracolumbar dogs without pelvic limb pain perception., Methods: Retrospective study of medical records of dogs selected for intensive rehabilitation treatment in paraplegic dogs with absence of pain perception on admission and during the whole treatment. Binary regression and multivariate logistic regression were used to analyze potential associations with the development of SW., Results: Autonomous SW was achieved in 48 dogs (59%). Median time to achieve SW was of 75.5 days (range: 16-350 days). On univariate analysis, SW gait was associated with younger age (P = .002) and early start of physiotherapy (P = .024). Multivariate logistic regression showed that younger age (≤60 months) and lightweight (≤7.8 kg) were positively associated with development of SW (P = .012 and P < .001, respectively). BCS, full-time hospitalization, and type and site of the lesion were not significantly associated with development of SW., Conclusions: Dogs with irreversible thoracolumbar lesion undergoing intensive physiotherapic treatment can acquire SW. Younger age and lightweight are positively associated with the development of SW gait., (Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.)

OBJECTIVE To determine the effectiveness of manual bladder expression in paraplegic dogs by comparing urine volumes measured by use of intermittent catheterization and ultrasonography. ANIMALS 36 paraplegic dogs. PROCEDURES 93 measurements of bladder volume were collected for the 36 dogs. Residual urine volume was determined by use of intermittent urethral catheterization and estimated by use of ultrasonography. RESULTS Manual bladder expression voided a mean of 49% of urine from the bladder in this population of dogs. There was no correlation (R 2 , 0.06) between the effectiveness of manual bladder expression and body weight. Ultrasonographic estimation of bladder volume had good correlation (R 2 , 0.62) with bladder volume determined by use of intermittent bladder catheterization, but clinically unacceptable variation for predicting actual bladder volume (mean difference, 22 mL; 95% confidence interval, -96 to 139 mL). CONCLUSIONS AND CLINICAL RELEVANCE Manual bladder expression was ineffective at completely emptying urine from the bladder of paraplegic dogs, but the effectiveness of the procedure was not affected by body weight. Manual bladder expression would likely be a useful procedure to prevent increases in pressure within the bladder. Ultrasonographic estimation of bladder volume could be a useful predictor of actual bladder volume, but it was susceptible to wide variations among dogs, and results should therefore be interpreted with caution.

Physiotherapy assessment of the equine athlete is carried out by qualified physiotherapists, who use a functional approach to the assessment of the horse. Observation, clinical reasoning, good palpation skills and implementation of outcome measures are skills used by these professionals in their assessment of the horse. Equine physiotherapists attempt, where possible, to use an evidence-based approach to the assessment of the equine athlete., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Physical therapy (physiotherapy, or PT) can be broadly defined as the restoration of movement and function and includes assessment, treatment, and rehabilitation. This review outlines the history, definition, and regulation of PT, followed by the core scientific principles of PT. Because musculoskeletal physiotherapy is the predominant subdiscipline in equine PT, encompassing poor performance, back pain syndromes, other musculoskeletal disorders, and some neuromuscular disorders, the sciences of functional biomechanics, neuromotor control, and the sensorimotor system in the spine, pelvis, and peripheral joints are reviewed. Equine PT also may involve PT assessment and treatment of riders., (Copyright © 2016 Elsevier Inc. All rights reserved.)

A good rehabilitation program takes into account the possible causes for the injury. Once the underlying cause of the injury is determined, a veterinarian can construct an appropriate rehabilitation plan and use the available electrophysical therapies to their greatest effect. Treating the horse correctly for the type and location of injury, and the stage of rehabilitation of the tissue, helps ensure full rehabilitation success. This article discusses when and how to use the most common electrophysical therapies in horses including transcutaneous electrical nerve stimulation, neuromuscular electrical stimulation, functional electric stimulation, pulsed electromagnetic field therapy, therapeutic ultrasound, laser therapy, shockwave therapy, and vibration therapy., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Physical treatment and rehabilitation play major roles in recovery and maintenance of the equine athlete, and many therapeutic measures are accessible by the veterinarian in general practice. An accurate diagnosis of the condition undergoing treatment is a requirement, and measurable parameters obtained at diagnosis allows for quantification of treatment outcomes. Therapeutic modalities accessible to the general practicing veterinarian are reviewed. Mechanisms of action, indications, and treatment protocols of thermal therapy, therapeutic ultrasound, extracorporeal shock wave, and laser are discussed. Manipulative therapies, including stretching and use of core strengthening exercises and equipment, are outlined., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Congenital radial head sub-luxation was diagnosed in a 7-month-old, neutered male shih tzu that presented with a limb deformity and severe lameness of the right fore limb. Radiography revealed a craniolateral sub-luxation of the right radial head, which was treated by radial head ostectomy, fixation of the radius to the ulna with a screw and joint stabilisation with suture-anchors and cerclage wire. Surgical treatment followed by physiotherapy resulted in a fully functional, well-aligned and non-painful elbow. To the authors' knowledge this is the first case report of a congenital radial head sub-luxation in a craniolateral direction in a dog and also one successfully managed with radial head ostectomy and radioulnar synostosis., (© 2015 British Small Animal Veterinary Association.)

This case report describes a new physical therapy technique, specifically the Wolfe Kinetic Technique, as adjunctive therapy in the treatment of severe osteoarthritis in a 20-yr-old Komodo dragon (Varanus komodoensis). This animal was managed with oral analgesics for 3 yr with fair to minimal response over time. Due to worsening of lameness and mobility, physical therapy was initiated. Ten treatment sessions were administered at 1-wk intervals. Within 1 mo the Komodo dragon exhibited marked improvement in gait and function, increased responsiveness to his environment, and increased mobility which continued to improve over the subsequent sessions. Although outcomes could not be measured by standardized objective measures, this study provides a reference for treatment of future cases and a foundation for future research substantiating treatment practices in animal physical therapy.

Management of trauma-induced chronic torticollis in raptors has historically been challenging. Euthanasia is common in affected birds because of their inability to maintain normal cervical position, although they may be able to function normally. To assess effectiveness of physical therapy of the neck and head as an adjunct treatment for this condition, a case-control study was done in raptors admitted to the Rocky Mountain Raptor Program from 2003 to 2010. Eleven cases were identified with a diagnosis of chronic torticollis resulting from traumatic brain injury. Five cases were treated with physical therapy of the head and neck, and 6 control cases did not receive any physical therapy for the torticollis. Of the control cases, 0 of 6 had resolution of the torticollis, 0 of 6 were released, and 5 of 6 were euthanatized. Of the treated cases, 4 of 5 had complete resolution of the torticollis and 5 of 5 were released. Resolution of torticollis differed significantly between cases receiving physical therapy and controls. These results indicate that physical therapy should be used as an adjunctive therapy in cases of chronic torticollis induced by trauma in raptors because it results in better resolution of the torticollis and increased likelihood of release.

A specific diagnosis is needed to perform optimal rehabilitation of orthopedic problems. A well-planned rehabilitation program is important for orthopedic patients when surgical repairs are mechanically weak (eg, when repairing fractures in skeletally immature patients or when repairing tendons or ligaments). Joint immobilization is sometimes used to protect weak surgical repairs. The duration of immobilization should be minimized, particularly in situations with potential loss of joint motion. Evidence-based information regarding specific modalities and techniques for rehabilitation of injured dogs and cats is generally lacking. The choice of modalities and techniques must be based on common sense, knowledge of rehabilitation techniques, and clinical experience., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Exoprostheses are devices that are secured to incomplete limbs to enable locomotion. By comparison, orthoses are devices externally applied to support or protect an injured body part. Orthoses also can be used to control, guide, protect, limit motion of, or immobilize an extremity, a joint, or a body segment. Exoprostheses and orthoses are a growing aspect of the physical rehabilitation of companion animals. They require precise design and fabrication. Patients and owners must be trained to use the devices. Exoprostheses and orthoses can have a profound beneficial impact on the mobility and the quality of life of companion animals., (Copyright © 2015 Elsevier Inc. All rights reserved.)

A 3.5 yr old spayed female Staffordshire terrier weighing 25.5 kg was presented with a 7 wk history of bilateral plantigrade stance in the pelvic limbs directly following an ovariohysterectomy procedure. Upon presentation, the dog had bilateral atrophy of the distal pelvic limb muscles, enlarged popliteal lymph nodes, and ulcerative wounds on the dorsa of her rear paws. Orthopedic examination revealed intact calcaneal tendons bilaterally and neurologic examination localized the lesion to the distal sciatic nerve. A diagnosis of compressive and stretch neuropathy was made affecting the distal sciatic nerve branches. Physical therapy modalities included neuromuscular electrical stimulation, ultrasound, and low-level laser therapy. Other therapeutic modalities included the use of orthotics and progressive wound care. The dog had increased muscle mass, return of segmental reflexes, return of nociception, and the ability to walk on pelvic limbs with higher carriage of the hock 15 mo following presentation. The use of custom orthotics greatly increased the quality of life and other physical therapy modalities may have improved the prognosis in this dog with severe bilateral plantigrade stance due to neuropathy.

Patients who have total joint arthroplasty have varying needs related to rehabilitation. In the short term, rehabilitation should be used in all dogs to identify high-risk patients and to minimize the likelihood of postoperative complications. Many patients undergoing total hip replacement recover uneventfully without needing long-term physiotherapy. All patients undergoing total knee replacement and total elbow replacement need rehabilitation to restore limb use and maximize their functional recovery. This article presents rehabilitation considerations for companion animals undergoing total hip replacement, total knee replacement, and total elbow replacement; postoperative complications and how to mitigate risks; and anticipated patient outcomes., (Copyright © 2015 Elsevier Inc. All rights reserved.)

A comprehensive physiotherapy plan for neurology patients manages pain, prevents secondary complications, and supports the health and function of musculoskeletal tissues during recovery. Neurologically impaired patients range in ability from complete immobility (tetraplegia/paraplegia), partial mobility (tetraparesis/paraparesis), mild ataxia, to pain only. Important considerations for the design of a physiotherapy program include access to the patient, level of staff support, and safety of staff, patient, and client during treatments. A thorough overview of the treatment plan and expected outcome should be discussed with the client at the onset of therapy and should be reviewed frequently, particularly as the patient's status changes., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Physical agent modalities can be effective components of the overall rehabilitation of small animals. This article reviews the effects, indications, contraindications, and precautions of cold, superficial heat, therapeutic ultrasound, and electrical stimulation., (Copyright © 2015 Elsevier Inc. All rights reserved.)

This article reviews some important studies regarding canine physical rehabilitation. Bones, cartilage, muscles, ligaments, and tendons undergo atrophy if loading is decreased. Knowledge of the changes that occur with immobilization and the time course of events helps in the development of a rehabilitation program to improve tissue integrity. Outcome assessment instruments are clinically useful indicators of patient progress and the success of rehabilitation programs. A number of physical modalities are used in canine rehabilitation, although there are relatively few canine-specific studies. Rehabilitation has specific benefits in the treatment of various orthopedic and neurologic conditions., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Optimal function after injury, surgery, or in patients with chronic conditions requires adequate motion in joints, muscles, tendon, fascia, and skin. Range of motion and stretching exercises are commonly used in companion animal rehabilitation programs to maintain or improve motion of musculoskeletal tissues. Range of motion exercises and stretching prevent adhesions from forming, help scar tissue remodeling, may improve muscle tone, and prevent future injury from occurring. Stretching is used to avoid loss of motion or to regain lost joint motion. Stretching is done manually, using external coaptation, or using therapeutic exercises. Careful documentation of range of motion is necessary., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Laser therapy is an increasingly studied modality that can be a valuable tool for veterinary practitioners. Mechanisms of action have been studied and identified for the reduction of pain and inflammation and healing of tissue. Understanding the basics of light penetration into tissue allows evaluation of the correct dosage to deliver for the appropriate condition, and for a particular patient based on physical properties. New applications are being studied for some of the most challenging health conditions and this field will continue to grow. Additional clinical studies are still needed and collaboration is encouraged for all practitioners using this technology., (Copyright © 2015. Published by Elsevier Inc.)

Cats have orthopedic problems, including osteoarthritis, fractures, and luxations that are positively impacted by physical rehabilitation. Most cats have an independent behavior that requires using a tactful approach to rehabilitation. Cats often do well with manual therapy and electrophysical modalities. Feline rehabilitation sessions may be shorter than canine rehabilitation sessions. Cats do best with therapeutic exercises when these exercises are linked to hunting, playing, or feeding., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Therapeutic exercises are the cornerstone of the rehabilitation programs of companion animals. Therapeutic exercises are used to improve active joint range of motion, to improve weight bearing and limb use, to build strength and muscle mass, and to increase conditioning (eg, endurance, speed). Each case is unique as chronicity, type of injury, patient signalment and temperament, owner compliance, and level of required functional recovery vary widely. Therapeutic exercises are also essential for partial return to work or performance and to learn to perform activities of daily living after injury or surgery., (Copyright © 2015 Elsevier Inc. All rights reserved.)

A 32-day-old, hand-reared, captive-born female clouded leopard (Neofelis nebulosa) cub presented as being unable to stand, ambulate, or adduct both hind limbs. The cub exhibited hyperextension of both tarsal joints and a flattened thorax, which limited mobility to "swimmer-like" movements. Neither congenital defects nor neurologic deficits were observed during the medical examination. Radiographic examination showed the thorax was compressed dorsoventrally, but no other skeletal abnormalities were detected. Based on clinical signs, the condition was more consistent with swimmer syndrome, which has been described in young offspring of several domestic species. Over the course of 3 wk, affected limbs were treated by intensive physiotherapy, corrective bandages were applied, and thermotherapy was used to improve circulation, which resulted in a complete recovery and development of subsequent normal ambulation. It is concluded that early diagnosis and treatment of this condition led to the resolution of clinical signs, resulting in normal development of the clouded leopard cub reported here.

A 50-day-old, female miniature schnauzer dog was presented for astasia, dorsoventral flattening of the thorax, hypoplasia of hind-limb muscles, stiffness of hind-limb joints, paddling leg motion, and panting. The dog was diagnosed with swimmers syndrome. The dog recovered completely following 40 days of home-care treatment that involved environmental and nutritional management along with intensive physiotherapy.

Practical Relevance: Physiotherapy is highly valued within human medicine and relatively well established for canine patients. Despite a popular misconception that feline patients will not cooperate with such treatment, physiotherapy is now increasingly being performed with cats. With cat ownership increasing in many countries, and an emergence of specialist physiotherapy practitioners, there is demand for effective postoperative and post-injury rehabilitation for any cat with compromised physical function due to injury, surgery or disease., Clinical Challenges: While physiotherapy and rehabilitation are potentially beneficial for cats, due to their independent nature feline patients certainly present a greater challenge in the pursuit of effective therapy than their canine counterparts., Audience: This two-part review article is directed at the primary care veterinary team. The benefits of physiotherapy and the various treatment modalities available to the qualified veterinary physiotherapist, as well as the non-specialist veterinarian and veterinary nurse or technician, are examined in this first part., Evidence Base: The benefits of human physiotherapeutic intervention are well documented, and there is good evidence for the effectiveness of most treatment modalities. Animal studies are still in their infancy, although some preliminary studies in dogs have shown good results.

Practical Relevance: There is an increasing demand for effective postoperative and post-injury rehabilitation for any cat with compromised physical function due to injury, surgery or disease., Clinical Challenges: The design of a suitable rehabilitation programme that will assist the recovery process, as well as ensure the return of neuromusculoskeletal control to the highest levels of function possible, requires a good understanding of feline behaviour, accurate assessment of the cat's condition and the correct implementation of a range of physiotherapeutic modalities., Audience: This two-part review article is directed at the primary care veterinary team. The clinical application of a variety of physiotherapeutic modalities in the rehabilitation of cats is examined in this second part., Evidence Base: Although evidence supporting the benefits of physiotherapy and rehabilitation with cats is sparse, many techniques, treatments and rehabilitation regimens successfully used on human patients are being readily adapted for animal use. Treatment recommendations described in this review are primarily based on the author's experience, and that of colleagues, except where specific reference is made to published evidence.